New to this Forum, but Questions...

Although I am new to this forum, I do make occasional posts on another forum on this site... the Prostate Cancer forum.

Two or three years ago my doctor diagnosed me "borderline diabetic" after a fasting blood sugar test reading of 139.  No other test was taken.  As a matter of fact, until I read Jeannie's post below, I did not even know there was another test.  He prescribed Metformin and I have taken it consistently since the diagnostic.

One year ago my doctor was very please after my A1c turned out in the high normal range (I don't remember what it was, but seems like it was something like 6.5). He said I was doing very well and I had been watching my intake carefully.  However for the last six months or so, I have not been watching it.  My fasting morning finger prick normally ran about 103.  Over the holidays, I binged.  No other word for it.

Two days ago I checked my morning glucose level at int was 129 in one finger, and 136 in another (go figure?).  In other words, it was high, was it not? Yesterday it was 127.  Today it was 120.

Would anyone venture a guess about my condition?  I will have a physical in early February.  How should I talk to the new doctor about this?  What should I ask him?

Gene 

A1C targets are moving. The traditional line has been that non-diabetics have A1C's no higher than 6%, and that diabetics should be no higher than 7%. Some standards now say that diabetics should be no higher than 6.5%. My area says 7%, but 6% "if it can be achieved without hypos". Some researchers suggest that the targets should be even lower. I certainly agree with Lanie that 6.5% is not a "good" A1C.

Lanie's right, reducing carbs and exercising are the first steps to take; however I don't agree with her suggestion pointing you to Dr Bernstein as your first reference. According to many, his low carb approach works well, but it is an extreme approach and very difficult to follow for most people. I'd say that it must be very difficult for anyone to follow, but there may be people out there to whom a 12 grams of carbs meal isn't a problem.

His own website says that his approach was "developed almost completely outside the mainstream of diabetology." Maybe its because few people have the will power to follow his recommentdations to the letter. A treatment that isn't followed isn't effective. There are many of us who have achieved good control of our diabetes without going the extreme low carb route. You might be better served by starting off with a more conventional and easier approach. If you want to, and are able to, you can work towards Dr Bernstein's ideals, but I think trying to start there is not going to work for many people.

Hi Metres, I have no idea how many carbs I eat in one day because I don't count them.  When Bernstein's book was recommended, I bought it and read it and found it very valuable.  However!  I also decided I'm not about to count carbs.  It's too tedious.  How I've worked out my eating plan is to cut out the obvious carbs like the "white" foods except cauliflower.  I'm not on meds so what I eat is what will make my blood sugar go up with no limits if I choose wrong foods.  So, what I've found that works for me is the meal plan as I described here (and in numerous other threads as well) which is based on what Bernstein suggests.  Vegetables have carbs of course but not near what you find in breads, pastas, rice or potatoes, so of course I do eat some carbs but I could never be as severe as what Bernstein suggests.  The reason I recommended his book is that it has a wealth of information about diabetes in general, the different kinds of medications prescribed, exercise tips, as well as diet.  I know I could not follow his approach of only so many grams of carbs per meal, but the entire practice of cutting down on carbs will drop everyone's blood sugar regardless.  Someone who now eats cereal and milk for breakfast or toast and jam will have high blood sugar readings post prandial and will have to take meds to cover them.  Having an Egg Beater omelet with some green peppers and mushrooms and a couple of slices of turkey bacon will not create a blood sugar spike.  I have a choice:  I can eat toast and jam for breakfast but I'll be on meds because my blood sugar will run too high, or, I can follow Bernstein's suggestions and stay medication-free, which is what I've been doing for a year now.  I don't conside this extreme.  I eat more food now than I did before actually and in the meantime I've also lost weight because I cut out the carbs. 

Hi:)

For some of us, eating carbs is just not a good thing. I had a blood sugar of 878 and A1c of 15.2 when I was diagnosed the end of October. I am on Metformin 1000 twice a day and 28 units of Lantus solorstar at night. I have found if I eat just 1/2 apple, I will get a bs of over 200. The same for a slice of whole wheat bread. By eating very low carb, I can stay between 80 and 120. This saves me from taking 4 extra shots of novolog a day. I read and folow Dr. Bernstein's book on eating very closely and all I can say is it works for me. Lanie is right to try to stay off meds as long as possible. Having your own body manage your bs is the best way to go as long as possible. I am also on prednisone and being weened off slowly and this will help my bs tremendously. Without Lanie's help pointing me to Dr. Bernstein's book, I wouldn't be doing this good. Plus, I am not so afraid to eat now. I have lost 60 pounds(another 4 since last Friday), so need to get more calories in my diet though. I feel like I am eating a lot but not enough calories yet. I don't want to EVER go through what I did last October so food does scare me! Without coming here and learning of the low carb diet, I would be on the ADA diet and really in trouble. My doctor, endo, and diabetes center okay this diet. They said they are changing to recommend it now and hiring a nutritionist who works with the low carb die. Each of needs to find what works for us and need to hear of all the choices. Lanie doesn't promote Dr. Bernstein but tells what works for her. Thank you Lanie, you have made my life easier:)

FWIW: I just read that the ADA has actually endorsed using a low carb diet for weight loss for type 2's. I couldn't bookmark the site because I am still in Buffalo and using a borrowed computer- but I'll find it when I get back if somebody is interested.

metres,

I sometimes think that we, in this forum, are a bit evangelistic when it comes to "Dr.B." and I have wondered if we scare off newly diagnosed seekers. I have tried to temper the message on occasion by suggesting alternative approaches such as the Insulin-Resistance Diet, reading Gretchen Becker's book -  Diabetes: the First Year which is  packed with good advice and personal anecdotes, and so forth. I think I am a good example- I eat moderate carb, maintain an A1c of 5.0 and I don't think medicine is satan. As my weight continues to drop, my insulin resistance decreases and my medication levels drop.

I think I might have been scared off by 'the no-white foods' diet as a newly diagnosed diabetic because so many of my favorite foods are white.  At the time I joined here, Jeannie was still eating grains and shared a lot of recipes and tips which helped me a lot to develop my new eating style. fergusc was the promoter of low carb eating and the two of them had spirited exchanges that made me really think about what I ate, and why.

Over time, as I adjusted  I was able to find low carb pastas, breads and wraps that taste good so that I can eat a wrap or a sandwich with my colleagues at a conference lunch. Eating cheese slices wrapped in lettuce leaves is not an option at company functions, especially when multimillion dollar accounts are eating with you or when you are seated at a table with the President and CEO and your manager has already requested a vegetarian dish for you. I learned what works best for my body by systematically testing my response to food combinations, but I don't think I'd be so well-adjusted if it hadn't been for the expression of differing opinions.

So, thanks for keeping the debate going!

sandy

 

Metres,
I don't follow any book or plan except to eat what my forebearers probably ate. Early homosapiens couldn't have manufactured pasta, bread, beer, crackers, cereals, doritos, or any of the other things found in the modern diet. Harvesting of grain or tuber crops could only happen once a year so much of the early human's food plan must have been made up of mostly meat, fish, vegetables and fruits. Any grains saved up would have required almost as much energy to grind as they produced in calories. This equal trade off would create balance in the diet, IMHO.

For some odd reason my body works much better when I do not consume foods that are manufactured (read :starch based) with the exceptions of sliced meats, cheeses and oils. Most of my food plan consists of food in it's most basic state. This way I can easily avoid the starchy part of the food. And amazing as it sounds I consume lots of olive oil, peanuts, avocados and some fatty meats like bacon and I'm still losing weight. I also can make a snack of a can of green beans, drained, smothered in olive oil and garlic. Or I'll have a whole banana with two tablespoons of peanut butter. Two hours later my blood sugar is usually 74 or 80. I don't know why this is... I just know that this works better than anything I've ever done. And (BIG BONUS HERE!) I'm almost never hungry. It's like the carbs keep your appetite going and without them I can forget to eat!

I just received my Diabetes Forcast magazine and there is a wealth of information in it about new and old meds, meters, exercise and a bunch of other stuff but nowhere is there a mention of cutting back on carbs. Seems to me that if too many carbs make our sugar go up then less of them will help it go down. And amazing as it sounds...last week I forgot to take my bedtime meds one night and still wound up with a morning reading of 128. Must be my body is forgetting to be diabetic as it loses weight... Don't know, don't care... just love to feel better for the first time in about 30 years!